RALEIGH, N.C. -- The North Carolina Department of Health and Human Services has issued a health advisory for a deadly new synthetic drug--acetyl fentanyl, more commonly referred to by its street name "China White."

According to the Centers for Disease Control and Prevention, acetyl fentanyl is a derivative of fentanyl--a prescription narcotic used to relieve severe or chronic pain.

Fourteen people in Rhode Island died using the drug between March and June 2013. Last June, the CDC issued an alert to public health agencies, state labs, coroners and medical examiners to look for the drug. The CDC also advised EMS personnel and hospitals to have adequate supplies of naloxone, an emergency antidote to opioid overdose.

Since the CDC's advisory, acetyl fentanyl has been linked to deaths in Pennsylvania, Louisiana and now North Carolina.The three North Carolina fatalities occurred in Sampson, Person and Transylvania Counties. The CDC said the drug is produced synthetically and has no legal uses in the United States. The CDC said the drug looks like, is packaged like and reacts like the drug heroin but is five times more potent. Heroin laced with fentanyl--a separate new synthetic drug combination--has killed at least 22 people in Pennsylvania counties.

In light of the recent acetyl fentanyl deaths, the CDC is recommending "increased vigilance" by public health agencies to look for symptoms consistent with opioid overdose. It also recommends these agencies work with laboratories to carry out enzyme-linked screenings to test for fentanyl and acetyl fentanyl.